Factors Related to Complex Regional Pain Syndrome-1 in Stroke

Complex regional pain syndrome – 1 (CRPS-1), known by various names is a devastating condition seen as secondary complication in post stroke patients. This condition not only reduces the functional level but also making the rehabilitation process difficult and affects over all quality of life of the patient. Its prevalence has been reported from 70% to 12.5% which usually occur between 2^nd and 3^rd month post stroke. Being multifactorial in nature its pathophysiology is unknown and hence difficult to manage. If the associated factors are known and understood, the problem can be prevented in post stroke population. This study is an attempt to explore various factors associated with CRPS-1 in stroke patients. A cross sectional survey was done on 63 stroke patients by using a questionnaire. Factors such as pain, age, gender, type, duration and side of stroke, hand dominance, recovery stage, tone, shoulder subluxation, edema, infusion to paretic arm and psychological factors etc were studied. 10% of the subjects were diagnosed as definite, probable or doubtful CRPS-1. Shoulder subluxation, spasticity, repeated invasive procedures on affected arm were factors found to be strongly associated with this complication. In the absence of exact etiology of CRPS-1 the therapy related factors explored through the study should be understood and given utmost importance for management of post stroke patients.